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Health Care: Constitutional Rights and Legislative Powers

Description: The health care reform debate raises many complex issues including those of coverage, accessibility, cost, accountability, and quality of health care. Underlying these policy considerations are issues regarding the status of health care as a constitutional or legal right. This report analyzes constitutional and legal issues pertaining to a right to health care, as well as the power of Congress to enact and fund health care programs. Following the recent passage of the Patient Protection and Affordable Care Act, P.L. 111-148, legal issues have been raised regarding the power of Congress to mandate that individuals purchase health insurance, and the ability of states to "nullify" or "opt out" of such a requirement. These issues are also discussed.
Date: May 18, 2010
Creator: Swendiman, Kathleen S.
Partner: UNT Libraries Government Documents Department

The Independent Payment Advisory Board

Description: This report, which provides an overview of the Payment Advisory Board, begins with a discussion of the rationale behind the creation of an independent Medicare board and briefly reviews prior proposals for similar boards and commissions. The report then describes the structure of the Board, the calculations and determinations required to be made by the Office of the Chief Actuary (the Chief Actuary) in the Centers for Medicare & Medicaid Services (CMS) that trigger a Board proposal, and the content of and constraints on Board proposals--including the Medicare productivity exemptions under Section 3401 of the The Patient Protection and Affordable Care Act (PPACA).
Date: April 17, 2013
Creator: Hahn, Jim & Davis, Christopher M.
Partner: UNT Libraries Government Documents Department

H.R. 2: The Children's Health Insurance Program Reauthorization Act of 2009

Description: This report summarizes changes to current law across the major provisions of H.R. 2 that would occur if The Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) were enacted.
Date: January 14, 2009
Creator: Baumrucker, Evelyne P.; Herz, Elicia J.; Peterson, Chris L.; Tilson, Sibyl & Gravelle, Jane G.
Partner: UNT Libraries Government Documents Department

Budget Control Act: Potential Impact of Sequestration on Health Reform Spending

Description: This report examines how automatic spending reductions triggered by the Budget Control Act of 2011 (BCA) might affect health reform implementation under the Patient Protection and Affordable Care Act (ACA). It is divided into three sections. The first section provides an overview of ACA's health insurance reforms and some analysis of the Congressional Budget Office's (CBO's) estimates of the impact of the law's implementation on federal direct spending and revenues. The second section examines the automatic spending reductions under the BCA. The final section discusses which types of health reform spending are likely subject to, or exempt from, those reductions.
Date: May 1, 2013
Creator: Redhead, C. Stephen
Partner: UNT Libraries Government Documents Department

Budget Control Act: Potential Impact of Sequestration on Health Reform Spending

Description: This report discusses the Budget Control Act of 2011 (BCA; P.L. 112-25), which established new budget enforcement mechanisms for reducing the federal deficit by at least $2.1 trillion over the 10-year period FY2012-FY2021. The BCA places statutory limits, or caps, on discretionary spending for each of those 10 fiscal years, which will save an estimated $0.9 trillion during that period. In addition, it creates a Joint Select Committee on Deficit Reduction (Joint Committee), which is instructed to develop legislation to reduce the federal deficit by at least another $1.5 trillion through FY2021.
Date: February 21, 2013
Creator: Redhead, C. Stephen
Partner: UNT Libraries Government Documents Department

Medicaid and Schools

Description: This report discusses the recent history and current issues facing Medicaid funding for certain health related costs under the Individuals with Disabilities Education Act (IDEA).
Date: February 17, 2009
Creator: Herz, Elicia J.
Partner: UNT Libraries Government Documents Department

The Independent Payment Advisory Board (IPAB): Frequently Asked Questions

Description: This report responds to frequently asked questions about the Independent Payment Advisory Board (IPAB), including the board's background, current status, controversial issues including legal challenges, and recent legislative efforts to repeal the IPAB.
Date: October 30, 2015
Creator: Hahn, Jim; Davis, Christopher M. & Liu, Edward C.
Partner: UNT Libraries Government Documents Department

Medicaid and Graduate Medical Education

Description: This report discusses Medicaid coverage of graduate medical education (GME) costs. GME costs are difficult to determine because teaching occurs in the context of patient care and research. There are direct GME (DGME) costs, which include residents' stipends, payments to supervising physicians, and direct program administration costs.
Date: February 17, 2009
Creator: Herz, Elicia J. & Tilson, Sibyl
Partner: UNT Libraries Government Documents Department

Individuals with Disabilities Education Act (IDEA) and Medicaid

Description: This report begins with an overview of Individuals with Disabilities Education Act (IDEA). It then discusses the distinction made in IDEA between medical services and health services. The report then summarizes the provisions in law that link Medicaid funding to IDEA. Next the report provides an overview of the complexities of Medicaid eligibility and covered services. Following that discussion, the report analyzes possible reasons why Medicaid appears to cover relatively little of IDEA health-related costs. Finally the report outlines possible legislative approaches with respect to Medicaid and IDEA.
Date: January 31, 2003
Creator: Apling, Richard N & Herz, Elicia J
Partner: UNT Libraries Government Documents Department

Medicaid: A Primer

Description: This report describes the basic elements of Medicaid, focusing on federal rules governing who is eligible, what services are covered, how the program is financed and how beneficiaries share in the cost, how providers are paid, and the role of special waivers in expanding eligibility and modifying benefits.
Date: December 19, 2005
Creator: Herz, Elicia J
Partner: UNT Libraries Government Documents Department

Implications of the Medicare Prescription Drug Benefit for Dual Eligibles and State Medicaid Programs

Description: This report discusses the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA, P.L. 108-173), which added a new Medicare prescription drug benefit, implemented in January 2006. This report focuses on MMA provisions that added a voluntary prescription drug benefit under a new Medicare Part D, and the effect of this new benefit both on individuals who are dually eligible for Medicaid and Medicare, and on state Medicaid programs.
Date: January 19, 2006
Creator: Tritz, Karen
Partner: UNT Libraries Government Documents Department

The Use of Modified Adjusted Gross Income (MAGI) in Federal Health Programs

Description: This report explores how modified adjusted gross income (MAGI) is defined differently across health programs such as Medicare, the health insurance exchanges under the Affordable Care Act (ACA), and Medicaid. It also discusses why MAGI is used, and how it is applied, specific to each program. The report covers that MAGI is used to determine (1) penalty amounts owed if a person does not comply with the individual mandate or whether an individual is exempt from the individual mandate; (2) eligibility for and the amount of a premium credit to purchase coverage through a health insurance exchange; and (3) Medicaid income eligibility for certain populations.
Date: February 25, 2016
Creator: Baumrucker, Evelyne P.; Davis, Patricia A.; Fernandez, Bernadette; Mach, Annie L. & Pettit, Carol A.
Partner: UNT Libraries Government Documents Department

Medicaid Rehabilitation Services

Description: This report describes Medicaid rehabilitation services, discusses major provisions of the Medicaid rehabilitation regulation, and provides various perspectives on the rehabilitation proposed rule.
Date: June 27, 2008
Creator: Binder, Cliff
Partner: UNT Libraries Government Documents Department

Health Care: Constitutional Rights and Legislative Powers

Description: This report analyzes constitutional and legal issues pertaining to a right to health care, as well as the power of Congress to enact and fund health care programs. It also discusses legal issues that have been raised regarding the power of Congress to mandate that individuals purchase health insurance, and the ability of states to "nullify" or "opt out" of such a requirement.
Date: April 5, 2010
Creator: Swendiman, Kathleen S.
Partner: UNT Libraries Government Documents Department

Medicaid and Children's Health Insurance Program (CHIP) Provisions in Affordable Health Care for America Act (H.R. 3962)

Description: This report summarizes the major provisions affecting Medicaid and CHIP in H.R. 3962 (as passed), including modifications made by the manager's amendment. The report focuses on provisions in Division B, Title VII--Medicaid and CHIP, plus selected provisions in Title IX--Miscellaneous Provisions. It also describes selected sections of Titles I and II of Division D, the Indian Health Care Improvement Act Amendments of 2009, related to improving access to Medicaid and CHIP for American Indians and Alaskan Natives.
Date: November 10, 2009
Creator: Herz, Elicia J.; Baumrucker, Evelyne P.; Binder, Cliff; Stone, Julie; Heisler, Elayne J. & Hoffman, Geoffrey
Partner: UNT Libraries Government Documents Department

Centers for Medicare & Medicaid Services: President’s FY2013 Budget

Description: This report summarizes the President's budget estimates for each section of the CMS budget. Then, for each legislative proposal included in the President's budget, this report provides a description of current law and the President's proposal. The explanations of the President's legislative proposals are grouped by the following program areas: Medicare, Medicaid, program integrity, and health insurance programs.
Date: April 9, 2012
Creator: Mitchell, Alison & Paulette, Morgan C.
Partner: UNT Libraries Government Documents Department

Medicaid Coverage of Long-Term Services and Supports

Description: This report provides a description of the various statutory authorities that either require or otherwise allow states to cover LTSS under Medicaid. The Appendix provides a brief legislative history of Medicaid LTSS from Medicaid’s enactment and initial coverage requirements for institutional care through the evolution of HCBS options available to states.
Date: December 5, 2013
Creator: Colello, Kirsten J.
Partner: UNT Libraries Government Documents Department

Medicaid and Graduate Medical Education

Description: This report discusses Medicaid coverage of graduate medical education (GME) costs. GME costs are difficult to determine because teaching occurs in the context of patient care and research. There are direct GME (DGME) costs, which include residents' stipends, payments to supervising physicians, and direct program administration costs.
Date: May 28, 2008
Creator: Herz, Elicia J. & Tilson, Sibyl
Partner: UNT Libraries Government Documents Department

Medicaid and CHIP Maintenance of Effort (MOE): Requirements and Responses

Description: This report summarizes the MOE requirements enacted under American Recovery and Reinvestment Act of 2009 and the Patient Protection and Affordable Care Act as modified by the Health Care and Education Reconciliation Act of 2010 and what these requirements have meant for states in terms of their actions to restrict Medicaid and/or CHIP eligibility. It also summarizes recent legislative activity to repeal the MOE requirements.
Date: May 25, 2011
Creator: Baumrucker, Evelyne P.
Partner: UNT Libraries Government Documents Department

Transitional Medical Assistance (TMA) Under Medicaid

Description: This report provides an overview of transitional medical assistance (TMA). While Section 1925 of the Social Security Act outlines the provisions requiring states to provide TMA for up to 12 months, states have considerable flexibility in designing and implementing their TMA programs.
Date: July 24, 2008
Creator: Grady, April
Partner: UNT Libraries Government Documents Department